[Possibilities and limits of a cytologic early detection program for endometrial cancer]

In a review of the most important examination methods for diagnosis of endometrial carcinoma so far published the efficacy of each of the individual methods is assessed according to uniform criteria. Only the specimens diagnosed as positive were taken as a basis for the rate of correct diagnosis, in order to facilitate comparison of the efficacy of the methods with one another. The validity of the methods is briefly outlined. Cytological diagnosis of endometrial carcinoma is appreciably less reliable than that of cervical carcinoma, regardless of the method used. The cytodiagnostic problems are different, depending whether exfoliative cytology or endouterine biopsy techniques have been used. Cancers of highly differentiated tumor cells are most seldom identified by the conventional smear techniques. Taking the endometrial carcinoma and endometrial hyperplasia patients at Erlangen University Gynecological Clinic between 1963 and 1981 as a basis, and limiting the scope of the study to high-risk adipose patients aged over 45, one-fifth of the carcinomas and one-fourth of the precancerous patients would not be included in a program based on risk factors. Of the Erlangen patients, a 5-year survival probability of 95% and more was calculated for women with tumors from cytologically highly differentiated cancer cells in histological stage I. It is particularly difficult to identify these patients cytologically, and the prognosis for them can hardly be improved further. Cytological nucleus grading proved a reliable prognosis factor, in particular for histologically undifferentiated tumors.(ABSTRACT TRUNCATED AT 250 WORDS)